Short-term Effects of Thoracic Manipulation in Shoulder Impingement

N/ACompletedNCT02083796

Universidade Federal de Sao Carlos110 enrolled

Overview

The hypothesis of this study is that thoracic spine manipulation would reduce pain in subjects with SIS and cause changes in scapular kinematics and muscle activity in subjects with impingement symptoms and in asymptomatic subjects. With this study, the investigators want to answer if possible changes in scapular motion and muscle activity following a TSM depend on the symptoms or if it is generic to individuals without shoulder dysfunction and not specific to subjects with shoulder impingement.

Subjects with shoulder impingement signs will be evaluated and will be compared with subjects asymptomatic for shoulder symptoms. Both subjects will be randomly assigned to one of two intervention groups: thoracic spinal manipulation (TSM) or sham intervention. We want to know if possible changes in scapular motion and muscle activity following a TSM depend on the symptoms or if it is generic to everyone. Also, we want to know if TSM reduces shoulder pain immediately and in a short-therm period.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

110

Conditions

Shoulder Impingement Syndrome

Interventions

Shoulder impingement_TSMPROCEDURE

A physiotherapist with 4 years of experience in manual therapy will administer the TSM targeting the middle thoracic spine of the subjects.

Asymptomatic_TSMPROCEDURE

A physiotherapist with 4 years of experience in manual therapy administered the TSM targeting the middle thoracic spine of the subjects.

Shoulder impingement_shamPROCEDURE

A physiotherapist with 4 years of experience in manual therapy administered the sham intervention targeting the middle thoracic spine of the subjects.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria (symptomatic subjects): To present with at least 3 of the following findings: * positive Neer impingement test, * positive Hawkins impingement test, * positive Jobe test, * pain with passive or isometric resisted shoulder lateral rotation, * pain with active shoulder elevation, * pain with palpation of rotator cuff tendons, * pain in the C5 or C6 dermatome region. Exclusion Criteria (symptomatic subjects): * signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process), * pregnancy * systemic illnesses * if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation * signs of complete rotator cuff tear or acute inflammation * cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis) * scoliosis * glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests) * previous upper extremity fracture or shoulder surgery. Exclusion Criteria (asymptomatic subjects): * any positive test for shoulder impingement * signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process), * pregnancy * systemic illnesses * if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation * signs of complete rotator cuff tear or acute inflammation * cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis) * scoliosis * glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests) * previous upper extremity fracture or shoulder surgery.

Locations (1)

Universidade Federal de São Carlos

São Carlos, São Paulo, Brazil

Outcomes

Primary Outcomes

Change in scapular orientation from first to third day

3D scapular kinematic (upward/downward rotation; internal/external rotation; anterior/posterior tilt) was assessed pre- and-post thoracic spinal manipulation and sham interventions at first and second days. At the third day of evaluation the measure was assessed only once.

Time frame: Day 1; day 2; day 3

Secondary Outcomes

Change in shoulder function from first to third day

Shoulder function was assessed at the beginning of each data collection day (days 1 to 3) using Disabilities of the Arm, Shoulder and Hand (DASH) and Western Ontario Rotator Cuff Index (WORC) questionnaires.

Time frame: Day 1; Day 2; Day 3

Change in scapular muscle activity from first to third day

3D scapular kinematic was assessed pre- and-post thoracic spinal manipulation and sham interventions at first and second days. At the third day of evaluation the measure was assessed only once.

Time frame: Day 1; Day 2; Day 3

Change in shoulder pain from first to third day

Shoulder pain was assessed pre- and-post thoracic spinal manipulation and sham interventions at first and second days. At the third day of evaluation the measure was assessed only once.

Time frame: Day 1; Day 2; Day 3

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.